Factitious disorder imposed on another

[7][8][9] This might include altering test samples, injuring a child, falsifying diagnoses, or portraying the appearance of health issues through contrived photographs, videos, and other ‘evidence’ of the supposed illness.

Aside from the motive (most commonly attributed to be gaining sympathy and attention), another feature that differentiates FDIA from "typical" physical child abuse is the degree of the premeditation and intent involved.

Whereas most physical abuse against children entails lashing out at a child in response to some behavior (e.g., crying, bedwetting, spilling food), assaults on the victim tend to be unprovoked and carefully planned, and are generally carried out in secrecy.

[6] Challenging cases that defy simple medical explanations may prompt health care providers to pursue unusual or rare diagnoses, thus allocating even more time to the child/victim and the abuser.

Even without prompting, medical professionals may be easily seduced into prescribing diagnostic tests, scans, operations, and therapies that may be painful, costly, or potentially injurious to the child.

Depending on their experience of medical interventions, some children may learn that they are most likely to receive the positive parental attention they naturally crave only when they are playing the ‘sick’ role in front of health care providers.

[1] The term is derived from Munchausen syndrome, a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves.

[6] They are named after Baron Munchausen, a literary character based on Hieronymus Karl Friedrich, Freiherr von Münchhausen (1720–1797), a German nobleman and well-known storyteller.

In 1785, writer and con artist Rudolf Erich Raspe anonymously published a book in which a fictional version of "Baron Munchausen" tells fantastic and impossible stories about himself, establishing a popular literary archetype of a bombastic exaggerator.

[38][39] "Munchausen syndrome" was first described by British endocrinologist and haematologist Richard Asher in 1951[40] as when someone invents or exaggerates medical symptoms, sometimes engaging in self-harm, to gain attention or sympathy.

[48] It was subsequently shown that the true odds were much greater once other factors (e.g. genetic or environmental) were taken into consideration, meaning that there was a significantly higher likelihood of two deaths happening as a chance occurrence than Meadow had claimed during the trial.

[50] Clark was released in January 2003 after three judges quashed her convictions in the Court of Appeal in London,[50][51] but suffering from catastrophic trauma of the experience, she later died from alcohol poisoning.

Meadow was involved as a prosecution witness in three other high-profile cases resulting in mothers being imprisoned and subsequently cleared of wrongdoing: Trupti Patel,[52] Angela Cannings[53] and Donna Anthony.

[54] In 2003, Lord Howe, the Opposition spokesman on health, accused Meadow of inventing a "theory without science" and refusing to produce any real evidence to prove that Munchausen syndrome by proxy actually exists.

[55] At appeal, High Court judge Mr. Justice Collins said of the severity of his punishment that "It is very difficult to think that the giving of honest, albeit mistaken evidence could - save in an exceptional case - properly lead to such a finding.

The article references the 1997 work of Southall, Plunkett, Banks, Falkov, and Samuels, in which covert video recorders were used to monitor the hospital rooms of suspected FDIA victims.

In a June 2004 appeal hearing, the Supreme Court of Queensland, Australia, stated: As the term factitious disorder (Munchausen's Syndrome) by proxy is merely descriptive of a behavior, not a psychiatrically identifiable illness or condition, it does not relate to an organized or recognized reliable body of knowledge or experience.

[61]The Queensland Supreme Court further ruled that the determination of whether or not a defendant had caused intentional harm to a child was a matter for the jury to decide and not for the determination by expert witnesses: The diagnosis of Doctors Pincus, Withers, and O'Loughlin that the appellant intentionally caused her children to receive unnecessary treatment through her own acts and the false reporting of symptoms of the factitious disorder (Munchausen Syndrome) by proxy is not a diagnosis of a recognized medical condition, disorder, or syndrome.

The essential issue as to whether the appellant reported or fabricated false symptoms or did acts to intentionally cause unnecessary medical procedures to injure her children was a matter for the jury's determination.

In his final conclusions regarding Factitious Disorder, Ryder states that: I have considered and respectfully adopt the dicta of the Supreme Court of Queensland in R v. LM [2004] QCA 192 at paragraph 62 and 66.

I take full account of the criminal law and foreign jurisdictional contexts of that decision but I am persuaded by the following argument upon its face that it is valid to the English law of evidence as applied to children proceedings.The terms "Munchausen syndrome by proxy" and "factitious (and induced) illness (by proxy)" are child protection labels that are merely descriptions of a range of behaviors, not a pediatric, psychiatric or psychological disease that is identifiable.

The terms do not relate to an organized or universally recognized body of knowledge or experience that has identified a medical disease (i.e. an illness or condition) and there are no internationally accepted medical criteria for the use of either label.In reality, the use of the label is intended to connote that in the individual case there are materials susceptible of analysis by pediatricians and of findings of fact by a court concerning fabrication, exaggeration, minimization or omission in the reporting of symptoms and evidence of harm by act, omission or suggestion (induction).

Where such facts exist the context and assessments can provide an insight into the degree of risk that a child may face and the court is likely to be assisted as to that aspect by psychiatric and/or psychological expert evidence.All of the above ought to be self evident and has in any event been the established teaching of leading pediatricians, psychiatrists and psychologists for some while.

For my part, I would consign the label MSBP to the history books and however useful FII may apparently be to the child protection practitioner I would caution against its use other than as a factual description of a series of incidents or behaviors that should then be accurately set out (and even then only in the hands of the pediatrician or psychiatrist/psychologist).

Therefore, in the case "The Secretary, Department of Family and Community Services and the Harper Children [2016] NSWChC 3", the expert testimony of Professor David Isaacs that a certain blood test result was "highly unlikely" to occur naturally or accidentally (without any speculation about motive), was sufficient to refuse the return of the affected child and his younger siblings to the mother.

[68] Lisa Hayden-Johnson of Devon was jailed for three years and three months after subjecting her son to a total of 325 medical actions – including being forced to use a wheelchair and being fed through a tube in his stomach.

[69] In the mid-1990s, Kathy Bush gained public sympathy for the plight of her daughter, Jennifer, who by the age of 8 had undergone 40 surgeries and spent over 640 days in hospitals[70] for gastrointestinal disorders.

However, in 1996, Kathy Bush was arrested and charged with child abuse and Medicaid fraud, accused of sabotaging Jennifer's medical equipment and drugs to agitate and prolong her illness.

My whole life I was made to believe I was sick, when I wasn't 'til I grew up now I blew up..." His mother's illness resulted in Eminem receiving custody of his younger brother, Nathan.

[80] At the trial, Pelletier's treating neurologist stated that several of her doctors suspected factitious disorder by proxy, and wanted her parents to stop encouraging her to be sick.